Botulinum toxin in fracture management: a scoping review

Area of Science:

• Orthopedics
• Regenerative Medicine
• Pharmacology

Background:

• Botulinum toxin (BoNT) is an emerging therapeutic agent in fracture management.
• Its potential benefits include improved fracture healing and immobilization, particularly for atypical fractures and patients with neuromuscular disorders.

Purpose of the Study:

• To conduct a scoping review of the literature on botulinum toxin's effectiveness in fracture healing and immobilization.
• To explore its application across various fracture types and patient populations.

Main Methods:

• A comprehensive literature search was performed across PubMed, Embase, and Cochrane databases.
• Included studies encompassed animal models, case reports, case series, cohort reviews, and randomized controlled trials.

Main Results:

• Fifteen studies were included, revealing mixed outcomes regarding BoNT's efficacy in enhancing bone healing and reducing muscle-induced displacement.
• BoNT demonstrated potential benefits in specific cases like atypical, periprosthetic fractures, and in patients with motor dysfunctions.
• Animal studies yielded inconsistent results concerning callous formation and bone mineral density.

Conclusions:

• Clinical evidence suggests botulinum toxin (BoNT) can serve as an immobilizing agent to promote fracture healing and mitigate complications.
• Further research is essential to reconcile findings between experimental and clinical studies and define optimal applications of BoNT in fracture management.